Derangements of Liver enzymes in Covid-19 positive patients of Pakistan: A retrospective comparative analysis with other populations

Author(s): Muhammad Sohaib Asghar, Mohammed Akram, Uzma Rasheed, Maira Hassan, Zehra Iqbal, Basmah Fayaz, Huzaifa Hayat, Ayesha Ather, Hamzah Hussain, Erum Syyed

Background & Objectives: COVID-19 is a global pandemic, also affecting Pakistan with its first case reported on 26th February 2020. Since then, it has been a total of 217,809 positive cases and 4473 deaths in Pakistan so far. Deranged liver function enzymes levels are prominently detected extra-pulmonary clinical manifestation of COVID-19 reported by at least one-half of the patients. Our study aimed to evaluate these derangements in our population.

Methods: A retrospective, observational study was conducted to include all the admitted patients having COVID-19 positive, and evaluated those for derangements of liver function enzymes (n=77). The statistical analysis was conducted to compare those derangements amongst the disease severity, prognostic markers, and death.

Results: Out of the 77 patients, 55 were admitted in the ward, 22 were in ICU, 61 of them recovered, while 16 deaths reported. The most deranged liver enzyme was found out to be Gamma-glutamyl transferase (51.94%), followed by Aspartate transferase (41.55%), Alanine transferase (28.57%), and Alkaline phosphatase (14.28%). Total bilirubin was deranged in only 10 patients, however, direct bilirubin was above the normal range in 33 patients, while indirect component in only 4 patients. Increased direct bilirubin, Aspartate aminotransferase, and Gamma-glutamyl transferase were associated with increased mortality, increased ICU admissions, increased neutrophils, lymphocytopenia, leukocytosis, and neutrophil to lymphocyte ratio>3, while Alanine aminotransferase and Alkaline phosphatase were not associated with the above factors.

Conclusion: The deranged values of liver function enzymes in COVID-19 are correlated with an increased number of ICU admissions, mortalities as well as prognostic markers.

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